Cardiac involvement in a child post COVID-19: a case from Lebanon
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BMJ Publishing Group
Abstract
We report on an 8-year-old boy, who presented to the emergency department at our institution with fever, generalised oedema and hypotension. Investigations revealed anaemia, thrombocytopenia in addition to elevated serum inflammatory markers, a negative COVID-19 PCR test and a positive COVID-19 IgG. His echocardiography was consistent with carditis in otherwise morphologically normal heart with depressed cardiac function, moderate-to-severe mitral valve regurgitation, moderate tricuspid regurgitation with an estimated right ventricular systolic pressure half systemic, trace aortic regurgitation, bilateral small pleural effusions, distended inferior vena cava and normal coronaries. He was started on inotropic support, intravenous immunoglobulin and methylprednisolone, and was transferred to the paediatric intensive care unit. To the best of our knowledge, this was the first case of multisystem inflammatory syndrome in children encountered in Lebanon. The presentation and management were thoroughly described in this article aiming to share our experience and to contribute to the rapidly emerging literature on this syndrome. © BMJ Publishing Group Limited 2021.
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Cardiovascular medicine, Covid-19, Infectious diseases, Child, Humans, Lebanon, Male, Mitral valve insufficiency, Sars-cov-2, Systemic inflammatory response syndrome, Tricuspid valve insufficiency, Acetylsalicylic acid, Amino terminal pro brain natriuretic peptide, Captopril, Cefpodoxime, Ceftriaxone, Creatinine, D dimer, Enoxaparin, Epinephrine, Furosemide, Immunoglobulin, Immunoglobulin g, Immunoglobulin m, Methylprednisolone, Milrinone, Nitrogen, Troponin t, Urea, Vancomycin, Acute kidney failure, Anemia, Aortic regurgitation, Article, Bradycardia, Breathing rate, Cardiovascular system examination, Carditis, Case report, Child health care, Child hospitalization, Chill, Clinical article, Clinical outcome, Computer assisted tomography, Conjunctivitis, Coronavirus disease 2019, Covid-19 serological testing, Creatinine blood level, Dehydration, Differential diagnosis, Disease severity, Drug response, Drug withdrawal, Echocardiography, Emergency ward, Face edema, Face mask ventilation, Fever, Fluid resuscitation, Follow up, Headache, Heart disease, Heart function, Heart left ventricle ejection fraction, Heart rate, Hospital discharge, Human, Hyperemia, Hypoalbuminemia, Hypotension, Lethargy, Liver injury, Low drug dose, Medical history, Methicillin resistant staphylococcus aureus infection, Mitral valve prolapse, Mitral valve regurgitation, Myalgia, Nasopharyngeal swab, Oxygen saturation, Pediatric intensive care unit, Pediatric multisystem inflammatory syndrome, Pericardial effusion, Peripheral edema, Physical examination, Platelet count, Pleura effusion, Protein blood level, Rash, Real time polymerase chain reaction, School child, Somnolence, Splenomegaly, Stomach distension, Systolic heart murmur, Tachycardia, Tachypnea, Thorax radiography, Thrombocytopenia, Thrombosis prevention, Tricuspid valve regurgitation, Urea nitrogen blood level, Venous thromboembolism, Diagnostic imaging